TRADITIONAL, NOT CONVENTIONAL.

Practicing Evidence-Based Medicine (April 8, 2014)

I’ve talked about evidence-based medicine (which is a movement in conventional medicine to evaluate and rank treatments for a given condition based on the scientific research) before. But that is only about a third of the actual practice of EBM. The other two-thirds is made up of the doctor’s particular expertise and of the patient’s values and desires.

The human element in health care is not something to be taken lightly. For one thing, the practice of any science is an art and varies considerably from doctor to doctor, both in general level of competence and in areas of particular skill. And patient values and preferences are not just important for the individual patient. Chiropractic has continued to exist in the United States for many decades despite the considerable efforts of the medical establishment to eradicate it only because people have demanded the continued delivery of a therapy that they found effective despite “expert opinion”. Nutrition is slowly and painfully becoming a part of mainstream medical practice for the same reason – people demand it.

It is often frustrating as a doctor to watch a patient choose a path to health that we just KNOW is wrong. It is easy for us to forget that our job to provide accurate advice and technical expertise in our specialty to the highest level possible, but that ultimately it’s the patient who chooses if and how s/he is going to get better.